UPMC Physician Resources

UPMC Physician Reaches Rare Milestone with 3000th Prostate Surgery

PITTSBURGH, May 1, 2014 Joel B. Nelson, M.D., chair of the Department of Urology at UPMC, has performed 3,000 radical prostatectomies since coming to Pittsburgh in 1999. He joins only a handful of surgeons in the world to reach this milestone.

Prostate cancer is the second most common cancer in American men, after skin cancer, with several treatments available for the disease. But often men shy away from surgical treatment because they believe it will leave them incontinent and impotent. Nerve-sparing radical prostatectomy is one of the most effective treatments because the cancer can be removed without harming nerves that control erections.

“The nerve-sparing approach not only removes the cancer but lowers the risk of impotence and bladder control problems, providing a better quality of life for the patient,” said Dr. Nelson. “Our vast experience distinguishes us from other programs and that helps give patients peace of mind when they seek treatment.”

Dr. Nelson has gained considerable recognition for both his clinical work and research. He has been featured in several publications due to the great strides he has made in the treatment of prostate cancer and is the recipient of multiple awards.

“We have seen remarkable results over the past decade. Currently, about 95 percent of patients undergo a bilateral nerve-sparing procedure with a prostate cancer-specific survival rate of 99.3 percent at five years and 98 percent at 10 years,” Dr. Nelson said.

Dr. Nelson also serves on the editorial boards for several scientific journals, including The Journal of Urology, and is an ad hoc reviewer for several other medical publications, including The New England Journal of Medicine.

UPMC East to Become Newest Site for UPMC Rehabilitation Institute

PITTSBURGH, May 1, 2014 – Construction is set to begin today on a new, 20-bed UPMC Rehabilitation Institute that is scheduled to open July 1 on the remodeled 6 East wing at UPMC East. It will mark the first Rehabilitation Institute location in Pittsburgh’s east-northeast corridor, complementing the current east-southeast location at UPMC McKeesport.

The facility will mark the ninth UPMC Rehabilitation Institute location as part of the system’s in-hospital network that provides specialized inpatient care for people needing physical, occupational and speech therapy after strokes or brain injuries, spinal cord injuries, various surgeries and other conditions. Children’s Hospital of Pittsburgh of UPMC also opened a Rehabilitation Institute this past winter. UPMC St. Margaret reopened its refurbished rehab unit in November, doubling its capacity to 26 beds.

“We are meeting a community need, in the area where our patients live,” said Mark Sevco, president of UPMC East. “It’s very exciting for us to open this in the eastern suburbs under the inpatient care of the Rehabilitation Institute. Utilizing existing space in a hospital that is very much in growth mode, just short of celebrating its second birthday, is a positive step for us. We continue to move forward with new clinical care.”

UPMC East recently was accredited by the independent Joint Commission as a primary stroke center. Stroke patients are expected to be among those receiving care at its new Rehabilitation Institute. Peter Hurh, M.D., specialist in inpatient rehabilitation and assistant professor in the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh School of Medicine, will serve as the medical director of the new UPMC East location. This Rehabilitation Institute will bring at least 15 new hires to the community, among them full-time nurses, therapists, care managers, liaisons and more.

“There clearly is a need for more quality in-hospital rehabilitation units,” said Dr. Hurh. “We hope to address that need by opening this new unit at UPMC East, and bringing the Rehabilitation Institute’s experience and expertise to the eastern suburbs and beyond.”

“In the past year, we opened 12 new beds at a remodeled UPMC St. Margaret unit, Children’s came on line, and now we’re launching this new unit at UPMC East,” said Tim Kagle, executive director, UPMC Rehabilitation Network. “UPMC is growing in rehabilitation and showing both clinical quality and community success providing the care that people want and need in the neighborhoods and the areas where they live.”

Construction is considered to be relatively simple, hence it is scheduled to require barely two months. The primary focus of the work will entail the transformation of the waiting room, known as The Wedge, into a therapy gym, where such new equipment as a Lite Gait – a body-weight supporting gait system – will be part of the therapeutic curriculum. A multi-purpose room also will become the Activities for Daily Living unit.

Regenerative Medicine Improves Muscle Strength and Function in Leg Injuries, Pitt Study Shows

PITTSBURGH, April 30, 2014 – Damaged leg muscles grew stronger and showed signs of regeneration in three out of five men whose old injuries were surgically implanted with extracellular matrix (ECM) derived from pig bladder, according to a new study conducted by researchers at the University of Pittsburgh School of Medicine and the McGowan Institute for Regenerative Medicine. Early findings from a human trial of the process and from animal studies were published today in Science Translational Medicine.

When a large volume of muscle is lost, typically due to trauma, the body cannot sufficiently respond to replace it, explained senior investigator Stephen F. Badylak, D.V.M., Ph.D., M.D., professor of surgery at Pitt and deputy director of the McGowan Institute, a joint effort of Pitt and UPMC. Instead, scar tissue can form that significantly impairs strength and function.

Pig bladder ECM has been used for many years as the basis for medical products for hernia repair and treatment of skin ulcers. It is the biologic scaffold that remains left behind after cells have been removed. Previous research conducted by Dr. Badylak’s team suggested that ECM also could be used to regenerate lost muscle by placing the material in the injury site where it signals the body to recruit stem and other progenitor cells to rebuild healthy tissue.

“This new study is the first to show replacement of new functional muscle tissue in humans, and we’re very excited by its potential,” Dr. Badylak said. “These are patients who can’t walk anymore, can’t get out of a car, can’t get up and down from a chair, can’t take steps without falling. Now we might have a way of helping them get better.”

For the Muscle Tendon Tissue Unit Repair and Reinforcement Reconstructive Surgery Research Study, which is sponsored by the U.S. Department of Defense and is continuing to enroll new participants, five men who had at least six months earlier lost at least 25 percent of leg muscle volume and function compared to the uninjured limb underwent a customized regimen of physical therapy for 12 to 26 weeks until their function and strength plateaued for a minimum of two weeks.

Then, study lead surgeon J. Peter Rubin, M.D., UPMC Professor and chair of plastic surgery, Pitt School of Medicine, surgically implanted a “quilt” of compressed ECM sheets designed to fill into their injury sites. Within 48 hours of the operation, the participants resumed physical therapy for up to 26 additional weeks.

The researchers found that three of the participants, two of whom had thigh injuries and one a calf injury, were stronger by 20 percent or more six months after the surgery. One thigh-injured patient improved on the “single hop test” by 1,820 percent, and the other had a 352 percent improvement in a chair lift test and a 417 percent improvement in the single-leg squat test. Biopsies and scans all indicated that muscle growth had occurred. Two other participants with calf injuries did not have such dramatic results, but both improved on at least one functional measure and said they felt better.

“This work represents an important step forward in our ability to repair tissues and improve function with materials derived from natural proteins. There will be more options to help our patients,” Dr. Rubin said.

“We think it’s remarkable that this approach was able to improve function among patients who were all well past the acute injury response phase and were not helped by the standard surgical procedures they had already had,” Dr. Rubin said.

The study also showed six months after an injury, mice treated with ECM showed signs of new muscle growth while untreated mice appeared to form typical scars.

The research team includes lead authors Dr. Rubin and Brian M. Sicari, Ph. D., and others from Pitt and the McGowan Institute for Regenerative Medicine. The project was supported by research grants from the U.S. Department of the Interior; and National Institutes of Health grants AG042199 and HL76124-6.

For more information about the trial, which aims to enroll 40 participants, go to http://www.mirm.pitt.edu/badylak/clinical/muscle.asp or call 412-624-5308.

The U.S. Department of Defense’s Limb Salvage and Regenerative Medicine Initiative and the Muscle Tendon Tissue Unit Repair and Reinforcement Reconstructive Surgery Research Study is collaboratively managed by the Office of the Secretary of Defense. The Initiative is focused on rapidly and safely transitioning advanced medical technology in commercially viable capabilities to provide wounded warriors the safest and most advanced care possible today.

Low Cholesterol in Immune Cells Tied to Slow Progression of HIV

PITTSBURGH, April 29, 2014 – People infected with HIV whose immune cells have low cholesterol levels experience much slower disease progression, even without medication, according to University of Pittsburgh Graduate School of Public Health research that could lead to new strategies to control infection.

The Pitt Public Health researchers found that low cholesterol in certain cells, which is likely an inherited trait, affects the ability of the body to transmit the virus to other cells. The discovery, funded by the National Institutes of Health (NIH), is featured in today’s issue of mBio, the journal of the American Society for Microbiology.

When HIV enters the body, it is typically picked up by immune system cells called dendritic cells, which recognize foreign agents and transport the virus to lymph nodes where it is passed to other immune system cells, including T cells. HIV then uses T cells as its main site of replication. It is through this mechanism that levels of HIV increase and overwhelm the immune system, leading to AIDS. Once a person develops AIDS, the body can no longer fight infections and cancers. Prior to effective drug therapy, the person died within one to two years after the AIDS diagnosis.

“We’ve known for two decades that some people don’t have the dramatic loss in their T cells and progression to AIDS that you’d expect without drug therapy,” said lead author Giovanna Rappocciolo, Ph.D., an assistant professor at Pitt Public Health. “Instead the disease is much slower to progress, and we believe low cholesterol in dendritic cells may be a reason.”

The discovery was made possible by using 30 years of data and biologic specimens collected through the Pitt Men’s Study, a confidential research study of the natural history of HIV/AIDS, part of the national NIH-funded Multicenter AIDS Cohort Study (MACS).

“We couldn’t have made this discovery without the MACS. Results like ours are the real pay-off of the past three decades of meticulous data and specimen collection,” said senior author Charles Rinaldo, Ph.D., chairman of Pitt Public Health’s Department of Infectious Diseases and Microbiology, and professor of pathology. “It is thanks to our dedicated volunteer participants that we are making such important advances in understanding HIV, and applying it to preventing and treating AIDS.”

Medications called combination antiretroviral therapy (ART) disrupt the viral replication process and can delay the onset of AIDS by decades.

However, even without taking ART, a small percentage of people infected with HIV do not have the persistent loss of T cells and increase in levels of HIV after initial infection. They can sometimes go many years, even more than a decade, without the virus seriously compromising the immune system or leading to AIDS.

Through the Pitt Men’s Study/MACS, eight such “nonprogressors” were assessed twice a year for an average of 11 years and compared to eight typically progressing HIV-positive counterparts.

Dr. Rappocciolo and her colleagues found that in nonprogressors, the dendritic cells were not transferring the virus to T cells at detectible levels. When taking a closer look at these dendritic cells, the researchers discovered that the cells had low levels of cholesterol, even though the nonprogressors had regular levels of cholesterol in their blood. A similar finding was shown for B lymphocytes, which also pass HIV to T cells, leading to high rates of HIV replication.

Cholesterol is an essential component of the outer membranes of cells. It is required for HIV to replicate efficiently in different types of cells. None of the study participants were taking statins, which are cholesterol-lowering medications that some people take to prevent vascular problems when cholesterol in their blood is too high.

When HIV was directly mixed with the nonprogressors’ T cells in the laboratory, those T cells became infected with the virus at the same rate as the T cells of the regularly progressing, HIV-positive participants. Indeed, T cells from the nonprogressors had normal levels of cholesterol.

“This means that the disruption is unlikely to be due to a problem with the T cells, further supporting our conclusion that the slow progression is linked to low cholesterol in the dendritic cells and B cells,” said Dr. Rappocciolo.

“What is most intriguing is that dendritic cells in the nonprogressors had this protective trait years before they became infected with HIV,” Dr. Rinaldo said. “This strongly suggests that the inability of their dendritic cells and B cells to pass HIV to their T cells is a protective trait genetically inherited by a small percentage of people. Understanding how this works could be an important clue in developing new approaches to prevent progression of HIV infection.”

Additional researchers on this study are Mariel Jais, B.S., Paolo Piazza, Ph.D., Todd A. Reinhart, Sc.D., Stella J. Berendam, B.S., Laura Garcia-Exposito, Ph.D., and Phalguni Gupta, Ph.D., all of Pitt Public Health.

This research was supported by NIH grants U01-AI35041 and R37-AI41870.

Children’s Epilepsy Monitoring Unit Conducting Remote EEG Monitoring

PITTSBURGH, April 25, 2014 – The Epilepsy Monitoring Unit (EMU) at Children’s Hospital of Pittsburgh of UPMC has begun conducting remote video monitoring of newborns in the Neonatal Intensive Care Unit at Magee-Womens Hospital of UPMC. Electroencephalographic (EEG) video monitoring began in early 2014, and since then, the EMU has monitored four babies at Magee.

The EMU team at Children’s can visually monitor babies, at the request of the Magee NICU, through a camera installed at their bedsides.

The EMU now performs outpatient EEG testing at Children’s East in addition to Children’s Pine Center and Children’s South.

UPCI Awarded Nearly $10 Million in Prestigious NCI Grants to Foster Cancer Research

PITTSBURGH, April 24, 2014 – The University of Pittsburgh Cancer Institute (UPCI) has been awarded two highly sought-after grants from the National Cancer Institute (NCI), totaling nearly $10 million, that will aid in bringing the latest research developments from bench to bedside and accelerate research into such things as rare tumors. UPCI is one of only 12 centers in the country to receive the NCI Experimental Therapeutics-Clinical Trials Network with Phase I Emphasis grant and the only center in Pennsylvania to receive a Lead Academic Participating Site (LAPS) grant under the NCI’s new clinical trials network.

That’s good news to patients like Patrick Jackson, who was diagnosed with a rare cancer known as grade I myxopapillary-ependymomas a few years ago. Jackson was referred to UPMC, where doctors treat just a couple of cases like his each year. He said any developments that can speed research and help cancer patients is a good thing.

“I am so fortunate that my ependymoma is low grade and has responded so well to treatment,” Jackson said. “I would just want people to know that there is hope, and there is nothing more comforting than having doctors familiar with your disease.”

The awards are further evidence of UPCI’s place as one of the premier academic cancer research centers in the country. UPCI is the only NCI-designated comprehensive cancer center in western Pennsylvania and through the network of its clinical partner, UPMC CancerCenter, enables several thousand patients to participate in clinical trials each year.

“Participating in a clinical trial is the optimal form of therapy for patients who are willing and able and allows us to learn something for the future along the way. We are grateful for the support of our patients and providers who have been an integral part of our success and helped us attain these two very important awards,” said Nancy E. Davidson, M.D., director of UPCI and the UPMC CancerCenter.

The NCI Experimental Therapeutics-Clinical Trials Network with Phase I Emphasis grant is led by UPCI Deputy Director Edward Chu, M.D. The $4.25 million, five-year grant funds complex research into new drug therapies.

“Our focus is on developing completely novel agents and combination regimens. We also are trying to understand how some of these new targeted therapies work and how we can apply science to individually tailor these new treatments to specific cancers,” Dr. Chu said.

UPCI is uniquely qualified to lead efforts in drug development because of the team approach that goes into the research, he noted, with expertise in pharmacokinetics, pharmacodynamics and basic science.

“We have a large patient base that allows us to do these novel first-in-man studies. The large majority of the patients who are referred to us have failed standard-of-care therapies, and they are looking for new treatments. There is only a small handful of cancer centers across the country that can offer the types of phase I clinical studies available to our patients here in Pittsburgh and the western Pennsylvania region,” Dr. Chu said.

The LAPS grant is part of the new National Clinical Trials Network (NCTN), designed to speed up the time it takes research to get from the lab to patients through technological advances and enhanced cooperation. The nearly $5 million award is led by Adam Brufsky, M.D., Ph.D., UPCI’s associate director for clinical investigation. The grant will fund the costs of maintaining a clinical trials infrastructure that permits patients to enroll in national trials led by the NCTN at more than a dozen sites across the UPMC CancerCenter network.

“This grant is tremendous validation from the NCI about the important and cutting-edge work that we are doing here at UPCI and our ability to shape what’s happening in cancer research across the country. We’re excited to play a vital role in this new system and expand access to trials all over western Pennsylvania,” Dr. Brufsky said.

As part of the award, Dr. Brufsky will lead a group at UPCI that includes Dwight E. Heron, M.D., Mark Socinski, M.D.; John Kirkwood, M.D., and Robert P. Edwards, M.D.

The NCTN replaces the cooperative networks that existed previously and were based on a model developed more than half a century ago. NCI officials hope to speed research through improvements in data management infrastructure, the development of a standardized process for prioritization of new studies, consolidation of its component research groups to improve efficiency, and the implementation of a unified system of research subject protection at over 3,000 clinical trials sites.

One important outcome of this new network will be the ability to facilitate the conduct of trials in rare tumors where patient accrual has always been very difficult. The availability of a national network of clinical trials sites to locate and enroll patients with unusual cancers should enhance the feasibility of conducting such studies. Also, as more cancers are molecularly defined and classified into smaller subsets, the new network structure will support the molecular screening studies needed to define and locate the smaller groups of patients who might be eligible for such studies.

“It has always been our mission at UPMC CancerCenter to provide the best care possible to patients in their own communities, and this grant enhances our ability to do that,” Dr. Davidson said.

UPMC Orthopaedic Surgeon to Co-Direct AAOS Course on Preparing for Healthcare Reform

PITTSBURGH, April 22, 2014 – The American Academy of Orthopaedic Surgeons (AAOS) is hosting Shifting Volume to Value: Preparing your Practice for Healthcare Reform June 5–6, 2014 in Washington, D.C.

Now in its third year, this course offers practical tools for success in a changing health care environment. Experts who shape health care policy will present on the value-based shifts in health care reform as they relate to orthopaedic practices. Orthopaedic surgeons, hospital administrators, medical directors, service line managers, quality managers, government or regulatory officials, healthcare purchasers, payers, or insurance executives, orthopaedic practice executives, and healthcare policy community members are encouraged to attend.

Anthony M. DiGioia III, MD, medical director of the Bone and Joint Center at Magee-Womens Hospital of UPMC, will co-direct this two-day course with Kevin J. Bozic, MD, MBA, from UCSF Medical Center.

Pitt, UPMC to Serve as the First U.S. Host of Global Health Conference

PITTSBURGH, April 22, 2014 – The biennial All Together Better Health conference will hold its first U.S. meeting in Pittsburgh this June to highlight the latest research on interprofessionalism and team-based health care delivery. The international conference serves as a forum for health system executives, educational leaders and policy makers to share new studies and shape the future of the health care workforce.

More than 500 research projects from 27 countries will be presented on the topics of interprofessional practice and education, an evolving concept in health care that uses a team approach to efficiently provide the best and most cost-effective care to each patient. UPMC and the University of Pittsburgh Schools of the Health Sciences are at the forefront of developing and implementing new models of interprofessional care.

“Teamwork is emerging as a critical strategy to improve outcomes and lower health care costs in the U.S. and around the globe,” said Everette James, J.D., M.B.A., director of Pitt’s Health Policy Institute. “We are pleased to serve as host for this important event, where participants will take stock of the latest research on new models of interprofessional care.”

Co-hosted by Pitt and The National Center for Interprofessional Practice and Education from June 6 to 8 on and around the University of Pittsburgh campus, this will be the seventh All Together Better Health conference. Past conferences have been held in Sydney, Vancouver and London, among others.

Sir David Nicholson, who stepped down March 31 as chief executive officer of England’s National Health Service, the world’s largest publicly funded health care system, will give the keynote address, providing his view on interprofessional care from both the payer and provider perspectives.

Steven Shapiro, M.D., UPMC’s chief medical and scientific officer; Mark A. Wagner, M.D., executive dean of education at Mayo Clinic; and Barbara Brandt, Ph.D., director of the National Center for Interprofessional Practice and Education at the University of Minnesota, will give the opening plenary session on advancing interprofessionalism in the U.S.

Pitt and UPMC were recently selected as a joint innovation incubator site for the National Center for Interprofessional Education and Collaborative Practice. The center is funded by the U.S. Department of Health and Human Services and charged with identifying ways to improve health, enhance patient care and control costs through interprofessional practice and education.

“As we transition from a payment system based on volume to value-based reimbursement under the Affordable Care Act, optimizing our health care workforce will be essential to improving access and controlling health costs,” said Mr. James, who served as 25th Pennsylvania secretary of health and is professor of health policy and management in Pitt’s Graduate School of Public Health. “To achieve this goal, providers are innovating at a furious pace to develop approaches that allow all health professionals to practice to the full extent of their training and education. With expansion of electronic health records and other new technologies, care teams – including doctors, physician assistants, nurse practitioners, pharmacists, physical therapists and others – have new tools to enhance collaboration.”

“In the rapidly changing practice environment, we need to ensure that research and evaluation of new interprofessional models is being fed back to health sciences schools to inform our curriculum. This feedback loop will help educational institutions train a collaboration-ready health care workforce,” said Susan Meyer, Ph.D., associate dean for education and professor in Pitt’s School of Pharmacy, and chair of the Pitt Working Group on Interprofessional Education.

Discounted rates for early registration to All Together Better Health VII are available through Friday, April 25.

Malfunction in Molecular ‘Proofreader’ Prevents Repair of UV-Induced DNA Damage

PITTSBURGH, April 21, 2014 – Malfunctions in the molecular “proofreading” machinery, which repairs structural errors in DNA caused by ultraviolet (UV) light damage, help explain why people who have the disease xeroderma pigmentosum (XP) are at an extremely high risk for developing skin cancer, according to researchers at the University of Pittsburgh School of Medicine and the University of Pittsburgh Cancer Institute (UPCI). Their findings will be published this week in the early online version of the Proceedings of the National Academy of Sciences.

Previous research has shown that a DNA-repair protein called human UV-damaged DNA-binding protein, or UV-DDB, signals for a repair when two UV-DDB molecules bind to the site of the problem, said senior investigator Bennett Van Houten, Ph.D., the Richard M. Cyert Professor of Molecular Oncology, Pitt School of Medicine, and co-leader of UPCI’s Molecular and Cell Biology Program.

“Our new study shows UV-DDB makes stops along the DNA strand and transiently attaches to it, causing a proofreading change in the protein’s conformation, or shape. If the DNA is damaged the protein stays, if the DNA is not damaged the protein leaves,” Dr. Van Houten said. “When it comes to a spot that has been damaged by UV radiation, two molecules of UV-DDB converge and stay tightly bound to the site, essentially flagging it for the attention of repair machinery.”

The researchers followed the trail of single molecules of UV-DDB by tagging them with light-emitting quantum dots, enabling them to watch the molecules jump from place to place in real time on both normal and UV-exposed DNA strands.

They also tracked a mutant UV-DDB protein associated with XP, an inherited, incurable disease of light sensitivity that affects about 1 in 250,000 people. They found that the mutant UV-DDB molecules are still capable of binding to DNA, but continued to slide along the DNA rather than staying put to signal where the fix was needed.

“Without this important damage control, UV-induced errors could accumulate to cause cell alterations that foster cancer development,” Dr. Van Houten said. “Like a bus with no brakes, the XP-associated UV-DDB complex stays on the road and sees possible passengers, but keeps going past the stop.”

Co-investigators include Harshad Ghodke, Ph.D., Ching L. Hsieh, Selamawit Woldemeskel, Simon C. Watkins, Ph.D., and Vesna Rapic-Otrin, Ph.D., all of the University of Pittsburgh School of Medicine; and Hong Wang, Ph.D., of North Carolina State University.

The project was funded by the University of Pittsburgh Cancer Institute Cancer Center Support grant CA 047904 and National Institutes of Health grant ES019566.

Pitt CVR and Sanofi Pasteur Collaborate to Assess the Effectiveness of a Dengue Vaccine

PITTSBURGH, April 15, 2014 – The University of Pittsburgh Center for Vaccine Research (CVR) and Sanofi Pasteur, the vaccines division of Sanofi, have entered a scientific collaboration to help assess the effectiveness of a dengue vaccine once introduced for immunization programs.

Pitt’s CVR is creating the new test to help assess the effectiveness of Sanofi Pasteur’s dengue vaccine candidate, which aims to reduce cases of dengue and the circulation of the virus in the population. The new test will tell if a person’s immunity to the mosquito-borne virus is due to a previous natural infection or from vaccination.

“Distinguishing whether a person’s immune response is from the vaccine or from infection by a mosquito can play an important role in the assessment of a candidate vaccine,” said Ernesto Marques, M.D., Ph.D., associate professor of infectious diseases and microbiology at Pitt’s CVR. “The goal of this test is to provide additional support in assessing the effectiveness of the vaccine after introduction.”

Dengue disease is caused by four types of dengue virus. It occurs mostly in tropical and subtropical countries, putting about half the world’s population at risk. It is endemic in Puerto Rico and locally acquired cases re-emerged recently in the Florida Keys and Texas. There is no treatment for dengue and no vaccine to prevent it.

It is estimated that around 100 million clinical cases of dengue occur annually, but a larger number of additional cases are so mild that the people who are infected don’t even realize it. Each year 500,000 people, including children, develop severe dengue, characterized by high fever, uncontrolled bleeding, respiratory distress and organ failure.

For every symptomatic case of dengue, there could be as many as three asymptomatic, or “silent” cases, according to recent international research. The new dengue test will be important to fully understand the impact of vaccination by providing additional support in assessing symptomatic versus silent infections, ultimately helping officials gauge how much a vaccine reduces disease transmission,” said Nicholas Jackson, Ph.D., head of dengue research and development for Sanofi Pasteur.

“This test also could be used by the government and health agencies to manage an immunization program,” added Dr. Marques. “It will give evidence that the vaccine works and could allow doctors to determine which populations still need vaccination so they can most effectively target their immunization outreach efforts.”

The Sanofi Pasteur dengue vaccine candidate was found to be safe and demonstrated protection against three of the four dengue virus types in the first efficacy clinical study, with results reported in 2012 in The Lancet, a medical journal. The study, which included 4,002 children, was conducted in a region of Thailand where dengue is highly endemic, and it was the first time a dengue vaccine candidate showed protection against the virus.

Data from Sanofi Pasteur’s ongoing phase III clinical studies with over 31,000 volunteers are expected to be available later this year and will document efficacy of their vaccine in a broader population and different epidemiological environments.

Pitt has a strong history in dengue research, most notably the first isolation and characterization of two of the four types of dengue virus in 1958 by William M. Hammon, M.D., Ph.D., then a professor of microbiology and epidemiology at Pitt’s Graduate School of Public Health. In 1980, Donald S. Burke, M.D., currently the CVR co-director and dean of Pitt Public Health, isolated dengue type 2 viruses in Bangkok.

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